Spontaneous coronary artery dissection angiography: Difference between revisions
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==Overview== | ==Overview== | ||
The current gold standard for diagnosing spontaneous coronary artery dissection (SCAD) is coronary angiography as it is widely available and the first-line imaging modality for patients presenting with acute coronary syndrome. The predominant angiographic feature of SCAD consists of smooth narrowing of varying severity and length involving mid-to-distal coronary segments, secondary to compression of the true lumen and/or expansion of the false lumen by the development of intramural hematoma. The typical appearance of extraluminal contrast staining, multiple radiolucent lumens, spiral dissection, or intraluminal filling defects is less commonly observed. Other | The current gold standard for diagnosing spontaneous coronary artery dissection (SCAD) is coronary angiography as it is widely available and the first-line imaging modality for patients presenting with acute coronary syndrome. The predominant angiographic feature of SCAD consists of smooth narrowing of varying severity and length involving mid-to-distal coronary segments, secondary to compression of the true lumen and/or expansion of the false lumen by the development of intramural hematoma. The typical appearance of extraluminal contrast staining, multiple radiolucent lumens, spiral dissection, or intraluminal filling defects is less commonly observed. Other angiographic findings associated with SCAD include [[coronary tortuosity]], [[myocardial bridging]], and [[fibromuscular dysplasia|coronary fibromuscular dysplasia]]. | ||
==Angiography== | ==Angiography== |
Revision as of 17:10, 27 February 2018
Spontaneous Coronary Artery Dissection Microchapters |
Differentiating Spontaneous coronary artery dissection from other Diseases |
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Diagnosis |
Treatment |
Case Studies |
Type 1 Type 2A Type 2B Type 3 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A.; Arzu Kalayci, M.D. [2]
Synonyms and keywords: SCAD
Overview
The current gold standard for diagnosing spontaneous coronary artery dissection (SCAD) is coronary angiography as it is widely available and the first-line imaging modality for patients presenting with acute coronary syndrome. The predominant angiographic feature of SCAD consists of smooth narrowing of varying severity and length involving mid-to-distal coronary segments, secondary to compression of the true lumen and/or expansion of the false lumen by the development of intramural hematoma. The typical appearance of extraluminal contrast staining, multiple radiolucent lumens, spiral dissection, or intraluminal filling defects is less commonly observed. Other angiographic findings associated with SCAD include coronary tortuosity, myocardial bridging, and coronary fibromuscular dysplasia.
Angiography
Angiographic findings include:
- Type 1: appearance on an angiography involves the presence of two intraluminal streams/lumens separated by a radioluscent flap of intima.
- Type 2: when the dissection plane is deeper in the vessel wall between the media and adventitial layers, formation of a hematoma can result in luminal narrowing which is seen as a stenosis on an angiography.
- Type 3: appearance mimics atherosclerosis. The dissection is typically shorter than that of type 2 (< 20 mm) and may have a hazy appearance.